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<p>Differences in pathological diagnostic systems can result in inconsistent grading and prognostic evaluation of phyllodes tumors (PTs) of the breast. This study compared three major diagnostic systems—the fifth edition of the <i>World Health Organization (WHO)</i> classification, the MD <i>Anderson</i> criteria, and the <i>International Group of Breast Pathologists</i> (<i>IGBP</i>) guidelines—to assess their prognostic relevance in borderline and malignant PTs. A retrospective cohort of 189 patients diagnosed with borderline phyllodes tumors (BoPTs) or malignant phyllodes tumors (MPTs) between 2009 and 2025 at the Fourth Hospital of Hebei Medical University was reviewed. All cases were reclassified according to the three diagnostic systems. Clinicopathological data and disease-free survival (DFS) were analyzed using Cox proportional hazards models and Kaplan–Meier survival analysis. Univariate analysis identified tumor border status and cellular atypia as independent prognostic factors. Multivariate analysis revealed that surgical approach and cellular atypia were independently associated with prognosis (<i>P</i> &lt; 0.05). Survival analysis showed that the IGBP criteria exhibited the highest discriminative ability in predicting DFS between BoPT and MPT patients (<i>P</i> = 0.0394). Among the diagnostic systems evaluated, the IGBP criteria offered superior prognostic stratification for MPTs. These findings advocate for the adoption of the IGBP classification to improve diagnostic accuracy, prognostic assessment, and treatment decision-making for patients with malignant phyllodes tumors.</p>

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The impact of different pathological diagnostic criteria on the prognosis of malignant phyllodes tumors of the breast

  • 期刊论文

  • 发表日期：

    2026年2月26日

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  • Lijing Cai,
  • Meng Yue,
  • Jiuyan Shang,
  • Ying jia,
  • Xuemei Sun,
  • Chang Liu,
  • Xinran Wang,
  • Si Wu,
  • Jinze Li,
  • Yueping Liu

摘要

Differences in pathological diagnostic systems can result in inconsistent grading and prognostic evaluation of phyllodes tumors (PTs) of the breast. This study compared three major diagnostic systems—the fifth edition of the World Health Organization (WHO) classification, the MD Anderson criteria, and the International Group of Breast Pathologists (IGBP) guidelines—to assess their prognostic relevance in borderline and malignant PTs. A retrospective cohort of 189 patients diagnosed with borderline phyllodes tumors (BoPTs) or malignant phyllodes tumors (MPTs) between 2009 and 2025 at the Fourth Hospital of Hebei Medical University was reviewed. All cases were reclassified according to the three diagnostic systems. Clinicopathological data and disease-free survival (DFS) were analyzed using Cox proportional hazards models and Kaplan–Meier survival analysis. Univariate analysis identified tumor border status and cellular atypia as independent prognostic factors. Multivariate analysis revealed that surgical approach and cellular atypia were independently associated with prognosis (P < 0.05). Survival analysis showed that the IGBP criteria exhibited the highest discriminative ability in predicting DFS between BoPT and MPT patients (P = 0.0394). Among the diagnostic systems evaluated, the IGBP criteria offered superior prognostic stratification for MPTs. These findings advocate for the adoption of the IGBP classification to improve diagnostic accuracy, prognostic assessment, and treatment decision-making for patients with malignant phyllodes tumors.